How does a PT who understands pain react to an “injury” while working out? part 2

‘ll answer some of the questions I posed in my personal low back “injury” story.

Why didn’t you freak out when you hurt your back and started limping? What if you tore something?
First off, there are certain signs (things I as a clinician can see on you, the patient) and symptoms (complaints that you as a patient have) that we look for to determine if there is a need for emergency care with low back pain. I didn’t have any “Red flags” that would require emergency care. It is very rare for non traumatic pains to need emergent care. On top of that, It is very unlikely that I irreparably damaged my low back while lifting a weight I lift often. Have you ever bent over and “pulled your back”? Or tried to pick up a box that you thought was light but ended up feeling a sharp pain that stopped you in your tracks? It is very unlikely to DAMAGE your low back while doing an activity that is low impact or one that you do often. You need a serious trauma, like getting hit by a car or a big fall to physically damage your spine. My spine is solid and durable, it can take a beating and so can yours (mine may be more solid and durable then yours but we’ll discuss that another time).

Without red flags or a serious trauma, I know it is safe to continue exercising. I know I won’t further “damage” my spine, but I can increase my pain. The pain I feel has very little to do with the “damage” I may or may not have in my spine. Whether or not I tore something is irrelevant. To find out whether or not I tore a ligament or muscle would not have changed my treatment for my low back pain. Having that knowledge doesn’t help me. So I don’t know and I don’t care whether or not I tore a ligament or muscle in my back.

Most people would freak out if they started limping. I know my limp was my reaction to the intense low back pain. It is a protective response. Different people will have different protective responses to pain. Some will feel intense tightness, some will feel VERY weak to the point. Thats not to say that these protective responses should always be ignored, just that in this case, my limp was OVERPROTECTIVE. So I did ignore it and went on with my workout. I stopped limping pretty soon after starting, so I wasn’t worried at all.

If anything doesn’t make sense or if something sounds like bullshit, call me out on it, question it.

Disclaimer: This is not medical advice.  This only applies to me in my situation for my body.